Athlete's foot is a rash caused by a fungus that usually appears between the toes. It’s not usually serious, but should be treated to stop it spreading to other parts of the body or other people. Athlete's foot most commonly affects the skin between the toes or on the bottom of the feet.
What causes it?
It’s caused by a number of fungal species which you can pick up from anywhere (typically communal areas such as pools, showers and changing rooms) or anywhere where you may walk around barefoot. The fungus on each bit of skin that falls away from someone else's feet can be picked up by you. Once your feet have been contaminated, the warm, dark, sweaty environment of feet cramped in shoes or trainers provides the ideal breeding ground for the fungus. However, athlete’s foot also occurs in dry, flaky areas.
Epidemiology
Dermatophytes that attack the skin are able to survive there because they have developed the ability to live on keratin, a protein which most other organisms cannot utilize. Keratin is the structural protein found in skin, nails and hair.
Tinea pedis (athlete’s foot) is very contagious, contracted by contact with spores that are shed by infected individuals onto the floors of swimming pool facilities, locker rooms, showers, etc. It is most contagious in moist, warm environments such as locker rooms or hot tub areas.
Most often, people get it by walking barefoot in areas where someone else with athlete’s foot has walked. The fungi can easily be transferred to your shoes, especially tight shoes in which air cannot circulate, where they then grow and ultimately cause a rash on your feet.
The infection can also be spread from one site on the body to other sites. Tinea pedis can spread to the groin (tinea cruris) or scalp (tinea capitis). Dermatophytes especially like to live in moist, warm areas of the body or on the scalp.
Symptoms and Diagnosis
There are three forms of tinea pedis:
• Interdigital - macerated, scaly, fissured skin occurs between the toes, especially in the web space between the 4th and 5th toes;
• Plantar (“moccasin foot”) - fine, powdery scale is present on a reddened background of the sole, heel, and sides of the foot;
• Vesicular (bullous) - an acute inflammatory reaction consisting of vesicles and pustules. Individuals may be asymptomatic or may experience burning, itching, or stinging.
Treatment
• Usually treated by topical antifungal creams for one to four weeks, applied once to twice daily
• Chronic infections can require oral antifungal therapy for anywhere from one to six weeks
• Secondary bacterial infections may occur and require oral antibiotics also
• Using antifungal powders on feet and shoes can help prevent reinfection
• Wearing open shoes can help with healing
Prevention
Keeping the feet clean and dry is one of the best methods of prevention. Other methods are well-ventilated shoes that fit properly and are not tight. Alternating shoes daily will allow shoes to dry thoroughly in between wearing. Socks should be dry and changed frequently. Wool socks draw moisture away from feet and are highly recommended. Wearing sandals or flip-flops in public showers or pool areas may also help prevent tinea pedis. The use of foot powders is controversial but may be helpful for persons susceptible to tinea pedis who have frequent exposures to areas where the fungus is suspected.
